Despite successes, vulnerability persists

Although Bangladesh has made significant achievements in areas like education and health, it still faces formidable challenges in economic and human development. Advances in education coverage have not been matched by improvements in educational quality, and while significant gains have been made in health indicators, health care for all remains a priority goal. Government social safety net programmes reach about 13% of all households in the country, but the poverty rate is 40% and the extreme poverty rate is 25.1%.Despiteall the progress that Bangladesh has made in the recent past, it stillrepresents one of the world’s most vulnerable economies, characterized by anextremely high population density, a low resource base, and high incidences ofnatural disasters (especially in rural areas), malnutrition, disability, povertyand inequality.

The recent progress achieved by the country, particularly since 1990, includescommendable successes in all sectors of the economy and social development,above all in the quantitative expansion of primary and secondary education,primary health care and economic indicators. These changes have led to markedimprovements in many socioeconomic indicators addressed by the MillenniumDevelopment Goals (MDGs): GDP per capita has increased steadily, the totalfertility rate has fallen, life expectancy has increased while infant andmaternal mortality rates have declined, and school enrolment rates haveincreased, as have access to clean water, sanitation and electricity. Thesechanges have been taking place in both rural and urban areas (Rahman and Ahmed,2005).

Considerable advances have also been achieved in mainstreaming women in thecountry’s development process. Women have played and continue to play animportant role in the successes of micro-credit, the ready-made garments sector,reducing the total fertility rate, improving child nutrition, greaterparticipation in education and reducing gender disparity in all spheres of life.Girls and women in Bangladesh have already achieved parity in the primaryeducation gross enrolment rate and in life expectancy at birth.

However, despite all these successes, some of the indicators mentioned abovestill remain very high in comparison to many other developing countries. Povertyremains high and income inequality has been increasing, while the quality ofhealth services and education are being eroded. The most disadvantaged aredisproportionately affected by these factors and are often unable to access thefruits of development. Strong social protection programmes are therefore neededboth to increase their participation in the development process and to reducethe severity of their poverty and exclusion (Rahman and Ahmed, 2005).

Recent trends in human development

Although a number of economic and social indicators have been showing quitepositive trends, other indicators related to social security have not been atall encouraging. Positive demographic trends have been observed in terms of areduced average household size as well as declining fertility rates, which inturn have resulted in changes in the age structure of the population and adecreased dependency ratio. However, the rapidly increasing trend of rural-urbanmigration due to ‘pull’ and ‘push’ factors has posed major challenges topolicy makers in terms of providing enough basic infrastructure, primary healthcare and education facilities in the cities, given the severe financial andspace constraints. The unemployment rate has been increasing, though slowly. Theeconomic dependency ratio – the ratio of the economically inactive populationto the working population – also remains high at 1.38, representing anobstacle to attaining sustainable household income growth. The economicallyactive female population is still very low and women constitute only 20% of theactive population.

Successes in expanding preschool, primary and secondary education have beennotable in Bangladesh. The huge increase in gross enrolment rates and theattainment of gender parity in primary enrolment have been the majorachievements. However, these achievements need to be viewed in the context ofhigh cohort dropout rates, low completion rates and the deteriorating quality ofeducation at all levels.

Bangladesh has made impressive gains in achieving high immunization coverage andreduced child and infant mortality and malnutrition rates. But despite thesesuccesses, most current rates are still quite high and need to be addressed morevigorously, particularly if the MDGs are to be achieved. Both fertility andmortality rates remain at high levels, raising concerns for poverty reduction.Significant gender and rural-urban discrimination continues to persist.Socioeconomic inequality in malnutrition as indicated by anthropometric measures(such as height and weight) appears to be very high. Maternal malnutrition,measured by body-mass index less than the critical value of 18.5, turns out tobe very high in the country. Moreover, the higher prevalence of malnourishedmothers in poor households has adverse implications for poverty reduction.

Access to clean water and hygienic sanitation has been increasing. Access toelectricity has also improved gradually. However, the average floor space perperson is very low for both the rural and urban population.

While significant positive trends in income growth have been observed,inequality has been rising very sharply, especially since 1990. Regional andrural-urban disparities in poverty rates have been notably high. Nevertheless,overall trends in human poverty have shown considerable improvement.

Social protection

Recognizing the challenges ahead, the government has emphasized socialprotection as one of the pillars of poverty reduction (GoB 2004).

Health services for all a top priorityThe availability of health facilities has been increasing in the countryover recent years. In 2001, there were 1,382 hospitals distributed across thecountry compared to 1,273 hospitals in 1998. Unfortunately, more recent data isnot available, but it can safely be said that the number of health facilitieshas continued to grow. Currently, almost every upazila(sub-district) has a hospital and every union[1] has a health centre.Although these health centres provide general health services, the focus is moreon maternal and child health. The distribution of immunization services, VitaminA, oral rehydration salts, and other essential supplies and services hasexpanded at a very rapid pace to cover almost the entire population. Because ofthe expansion of services, it is claimed that Bangladesh has made exceptionalprogress in family planning and health care services. In 2002, it was estimatedthat there were 28 physicians, 57 mid-level personnel and 76 hospital beds per10,000 persons. That same year, 53.9% of total health expenditures were financedfrom the state budget, 41.8% from health insurance, and 4.3% from the paymentfor services (Rahman and Ahmed, 2005).

Providing quality health services to all is one of the areas of emphasis for thegovernment, which is why budgetary allocations for health have been increasingevery year. In the 2007-2008 budget, health has received the sixth highestsectoral allocation, BDT 54.7 billion (USD 809.2 million), which is 6.3% oftotal expenditure. However, while this represents a 10.4% increase in theabsolute amount allocated to health in comparison to last year’s budget, itreflects a decline in the percentage share of the budget allocated to health(Rahman et al, 2007).

Education: advances in quantity notmatched by qualityAlthough Bangladesh has made significant advances in increasing thegross enrolment rate in primary education (105.1% in 2005) and in achievinggender parity in this regard (with a boys/girls ratio of 0.99 in 2005), the highand increasing rate of dropout (48%) and its negative impact on completionrates, along with the still existing gender gaps in secondary and tertiaryeducation, remain sources of great concern. The difference in these rates acrosssocioeconomic groups is another cause of concern, as it hinders the achievementof education for all. While the overall net enrolment ratio is 80.5% (2005), therates for the poor and the non-poor are 73.4% and 87.5% respectively (BBS,2006).

The government provides free primary education for all children and heavilysubsidizes secondary and tertiary education for most. More than three fourths ofprimary schoolchildren attend government schools and more than 12% attendgovernment-subsidized schools. The proportion of government schools issignificantly higher in rural than in urban areas (BBS, 2006). However, thequality of these government and subsidized schools raises a huge question mark.

The sectoral allocation for education in the budget has been increasing. Thetotal allocation for education in the 2007-2008 budget accounts for almost 14%of total expenditure. This reflects a 13% increase in education spending.However, since there is no allocation dedicated specifically to improving thequality of education, this increase will probably not bring about any meaningfulpositive change in primary education (Rahman et al, 2007).

Social safety nets target the poor but donot reach them allThe government and development partners arecurrently implementing some 27 social protection programmes, of which six arefood-based. There are a several more in the pipeline, as well as others beingimplemented by bilateral and multilateral agencies in partnership with nationalNGOs.The major food-based programmes, which benefit around 1.5 million poor peopleannually, are Food-for-Work, Vulnerable Group Development, Vulnerable GroupFeeding and Gratuitous Relief.

All of the social safety net programmes combined cover about 13% of allhouseholds in the country. The coverage is higher in rural areas (15.6%) than inurban areas (5.5%). Although the social safety nets are targeted for theprotection of the poor in general and the extreme poor in particular, thecoverage of these programmes is somewhat insignificant compared to the incidenceof poverty and extreme poverty in the country. The head count rate of poverty is40.0% and of extreme poverty 25.1% (BBS, 2006). Rather high rates of leakages inthe safety net programmes are reported in several studies (e.g. World Bank,2006). Significant regional variations are also observed in coverage (BBS, 2006)which seems to reflect the relative political strengths of the regions.

Although current efforts fall far short of actual needs, the government has beentrying to increase the extent of social safety net programmes in the country.The 2007-2008’s budget has provided for a significant increase in the volumeof expenditure on social safety net programmes. The total budget for theprogrammes has increased by one third of last year’s amount. Figure 1 showsthe significant rise in the budgetary allocation for social safety netprogrammes this year in terms of both amount and proportion (Rahman et al, 2007).

Whilethe above facts and figures correspond to the social protection initiatives runby the government, there are substantial programmes run by NGOs as well(including micro-credit programmes). In order to calculate a best estimate ofthe poverty targeting of social protection in Bangladesh, Rahman and Ahmed(2005) consider the overlap of programmes and come up with an overall povertytargeting rate of 34%, i.e., one in every three poor people. This implies that22.3 million poor people in Bangladesh currently receive some form of socialprotection assistance from the government and/or NGOs – but twice as many donot.